The role of contractual arrangements in improving health sector ...

Egypt
are governed by their own set of rules and regulations, have separate budgets, and exercise
more autonomy in daily operations. However, from a political perspective, the Ministry of
Health and Population has a controlling share of decision-making in parastatal organizations.
Private sector
Private sector provision of services includes for-profit and non-profit organizations and
covers everything, including traditional midwives, private pharmacies, private doctors and
private hospitals of all sizes. Also in this sector are a large number of nongovernmental
organizations providing services, including religiously affiliated clinics and other charitable
organizations, all of which are registered with the Ministry of Health and Population as well
as the Ministry of Social Affairs.
There is another category of health care providers belonging to professional syndicates.
Most of these are operating through an insurance scheme consisting of a per-capita fee
combined with co-payments from beneficiaries, and their services are subject to a restricted
range of inclusions as well as a ceiling level of cost per contract period.
Private facilities
After the declaration of an open economic policy in 1974, the private health sector
began to grow. Between 1975 and 1990, the total number of private beds grew significantly.
Private care providers in Egypt range from large modern hospitals to smaller hospitals, day
care centres, polyclinics and individual clinics.
Religious clinics operated by religious social agencies, a predominant type of
nongovernmental organization, are perceived to be popular and successful providers of
ambulatory health care in Egypt.
Nongovernmental organizations for health services are increasingly localized in the
larger provincial cities, particularly those governorate capitals with medical universities and
teaching hospitals. Those in metropolitan Cairo are known for their quality medical care,
thriving on low-cost services that are readily accessible to low-income households. These are
mostly staffed by senior to mid-level university medical staff.
Recently, nongovernmental organizations have started to hire university consultants and
to introduce modern technology. This situation not only increases their power and
participation in the health care system, but also enhances access and the willingness of the
population to utilize their facilities.
Nongovernmental organization health care providers rarely offer health education,
provide public information and awareness campaigns, conduct health outreach to their
patients and communities or promote preventive care.
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